License holder summary

BLAKE E NICHOLS is a Graduate Medical Trainee licensed to practice in Pennsylvania. The address on file for BLAKE E NICHOLS is Mesquite TX 75181. This medical practitioner license is not current. The license was granted 04/24/2012 and expired on 06/30/2015.

Department of State

Board of Medicine

BLAKE E NICHOLS
Graduate Medical Trainee
License number
MT201270
Date granted
04/24/2012
Date expires
06/30/2015
Class
Graduate Medical Trainee
Status
Inactive
Address
Mesquite TX 75181
medicinepa.com
ID 37555607
LAST UPDATED 2024-02-29 14:27:50 UTC

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